Tag Archives: cervical cancer

HIV+ and worried about cancer? – You should be, read this and find out why.

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Breakthroughs in medicine made it so a HIV diagnosis is no longer a death sentence; staying well with the illness is way less complicated than it used to be. That is, unless you are HIV-positive and get cancer.

Article via NewsWeek

A study conducted by researchers at the University of Utah, the National Cancer Institute and the American Cancer Society and published earlier this week says HIV patients in the U.S. are much less likely than the general population to receive treatments for cancer, whether it has affected the gastrointestinal system, lungs, cervix, prostate, breast or blood.

Patients with HIV have a significantly higher risk for certain cancers, known clinically as AIDS-defining cancers. These include Kaposi sarcoma (a soft tissue cancer that causes lesions in the lymph nodes and mucous membranes), cervical cancer and non-Hodgkin lymphoma. The diagnosis of any of these cancers for someone who has HIV is considered a clinical sign that the infection has progressed to AIDS.  (Don’t know the difference between HIV & AIDS? – Click here to read more).

According to the National Cancer Institute, people with HIV are several thousand times more likely than people without the disease to develop Kaposi sarcoma. They are 70 times more likely to develop non-Hodgkin lymphoma. HIV-positive women are five times more likely to be diagnosed with cervical cancer. In addition, HIV increases the risk for most common cancers, including those in the breast, prostate and lungs and colorectal cancer.

HIV is also often associated with other viruses that can cause or are related to certain cancers. For example, patients diagnosed with HIV may test positive for the human papillomavirus, which causes cervical cancer and some other types of cancers of both the male and female reproductive systems. HPV is also the cause of some head and neck cancers. Other viruses often diagnosed in people with HIV are Epstein-Barr and hepatitis B or C, all of which are linked to certain cancers.

To better understand how cancer specifically affects the HIV-positive community, researchers looked at data from the National Cancer Data Base on non-elderly adults diagnosed with several common cancers from 2003 to 2011, comparing 10,265 patients with an HIV diagnosis and 2,219,232 without. The researchers looked at rates of common types of cancer treatments across both populations, including chemotherapy, surgery, radiation or any combination. The result were published in the medical journal Cancer.

After adjusting for factors such as whether patients had health insurance, the researchers found that across the board, HIV-positive cancer patients were still significantly less likely to receive standard oncology treatments. For example, 32 percent of HIV-positive patients with lung cancer weren’t receiving treatment, versus 13.6 percent of lung cancer patients without HIV. HIV-positive patients with cancer of the upper gastrointestinal tract were more than twice as likely to go without treatment than those who didn’t have HIV. These disparities still existed for HIV patients who were privately insured, but those on Medicare or Medicaid, or uninsured, were even less likely to get cancer treatments.

However, the authors say the study shows health insurance isn’t the only cause behind the cancer treatment disparities. One finding indicates race and ethnicity could contribute to limited medical care: HIV patients who were black tended to fare worse. The authors also suggest the disparities could be driven by the lack of research on the relationship between cancer and HIV—for example, whether certain chemotherapies and cancer drugs are safe to use on HIV-positive patients.

“HIV-infected patients with cancer have historically been excluded from cancer clinical trials, thereby limiting the applicability of clinical trial results for this population,” the researchers write in the conclusion of their study. Oncologists often feel less confident when treating these patients, which results in poor survival outcomes.

Rates of cancer mortality among patients with HIV/AIDS have decreased significantly since the introduction of antiretroviral drugs. These drugs lower the amount of virus circulating in the blood, which boosts immune system function, preventing the HIV virus from progressing to AIDS. The introduction of these antiretrovirals in the marketplace in the 1990s also significantly reduced the rates for Kaposi sarcomas and non-Hodgkin lymphoma.

But antiretroviral drugs don’t fully restore immune system function, and their efficacy slowly diminishes over time, leaving HIV patients susceptible to cancers later in life. Additionally, many of these drugs are still relatively new, and no one knows for sure what the long-term impact may be for patients who take them for the full duration of their life. Regardless of these factors, the older a person is, the higher his or her risk for cancer.

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HIV drug used to reverse effects of virus that causes cervical cancer

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A commonly-used HIV drug has been shown to kill-off the human papilloma virus (HPV) that leads to cervical cancer in a world-first clinical trial led by The University of Manchester with Kenyatta National Hospital (KNH) in Nairobi.
Drs Ian and Lynne Hampson, from the University’s Institute of Cancer Sciences and Dr Innocent Orora Maranga, Consultant in Obstetrics and Gynaecology at KNH in Nairobi examined Kenyan women diagnosed with HPV positive early stage cervical cancer who were treated with the antiviral HIV drug lopinavir in Kenya.
The study looked at 40 women with both high and low-grade pre-cancerous disease of the cervix and the antiviral drug, normally used orally to treat HIV, was self-applied directly to the cervix as a pessary.
The results, due to be presented at two international scientific conferences later this month and next, showed a high proportion of women diagnosed with HPV positive high-grade disease returned to normal following a short course of the new treatment.
The findings build on previous peer-reviewed laboratory based research carried out by Drs Hampson and will be submitted to a journal soon. They have been described by an independent leading specialist in gynaecological cancer as very impressive.
The 40 women, who were all HPV positive with either high-grade, borderline or low grade disease, were treated with one capsule of the antiviral drug twice a day for 2 weeks. Repeat cervical smears showed a marked improvement within one month of the treatment although after three months, there was a definite response. Out of 23 women initially diagnosed with high-grade disease, 19 (82.6%) had returned to normal and two now had low-grade disease giving an overall positive response in 91.2%.of those treated. Furthermore the 17 women initially diagnosed with borderline or low-grade disease also showed similar improvement.
Photographic images of the cervix before and after treatment showed clear regression of the cervical lesions and no adverse reactions were reported.
Dr Ian Hampson said: “For an early stage clinical trial the results have exceeded our expectations. We have seen women with high-grade disease revert to a normal healthy cervix within a comparatively short period of time.
“We are convinced that further optimisation of the dose and treatment period will improve the efficacy still further.
“It is our hope that this treatment has the potential to revolutionise the management of this disease most particularly in developing nations such as Kenya.”
Cervical cancer is caused by infection with human papilloma virus (HPV) and is more than five times more prevalent in East Africa than the UK. In many developing countries, HPV-related cervical cancer is still one of the most common women’s cancers accounting for approximately 290,000 deaths per year worldwide. The same virus also causes a significant proportion of cancers of the mouth and throat in both men and women and this disease is showing an large increase in developed countries, such as the UK, where it is now more than twice as common as cervical cancer.
Dr Lynne Hampson said: “Current HPV Vaccines are prophylactics aimed at preventing the disease rather than curing or treating symptoms. Other than surgery, as yet there is no effective treatment for either HPV infection or the pre-cancerous lesion it causes which is why these results are so exciting.
“Further work is needed but it looks as though this might be a potential treatment to stop early stage cervical cancer caused by HPV.”  On a global scale HPV is the most common sexually transmitted disease.  Although in the developed world vaccination programmes against HPV are well underway, these are not effective in women already infected with the virus. The current vaccines do not protect against all types of HPV and they are expensive, which can limit their use in countries with low resources.
The researchers believe their findings offer a potential cheap and preferably self-administered treatment that could eliminate early-stage HPV infections before these have developed into cancers would therefore have distinct health advantages. Approximately 300,000 women are dying from cervical cancer per annum which is equivalent to 800 per day, one every two minutes mostly in low resource settings.
The research has been backed by Lord Saatchi, whose wife novelist Josephine Hart died of ovarian cancer and has submitted a Private Member’s Medical Innovation Bill to Parliament which he argues would promote “responsible” innovation for medics to try new treatments without the fear of negligence claims. The bill comes amid claims there is currently an estimated average time lag of 17 years for a new treatment or research evidence to reach clinical practice in the UK.
Lord Saatchi said: “What Drs Lynne and Ian Hampson have done is amazing – a classic case of innovation. The fact that they needed to run their trial in Nairobi and that even now there is no guarantee the treatment will be available in the UK any time soon, is a source of immense frustration.”
Dr Ian Hampson added: “This is not something we could have done in the UK due to the associated costs and red tape. We have full ethical approval in Kenya and chose to conduct the trial there because of the extreme need for a self-applied treatment for early stage cervical cancer.“During the trial we provided 820 women with free cervical smear testing in addition to a range of other free medical tests that are not routinely available in Kenya. This was essential in order to identify women with HPV related cervical disease so that we could treat them with lopinavir. It is very significant that during this process we also identified five women who already had invasive cervical cancer and these were immediately referred for surgery.”

The research was funded by the UK Philanthropist Mr Ken Chorlton, the Caring Cancer Trust, United in Cancer Charitable Trust, The Humane Research Trust, Quest Cancer, the Cancer Prevention Research Trust and Hologic.
Professor Pierre Martin-Hirsh, Consultant in Gynaecological and Oncologist and Associate Editor in Chief, the British Journal of Obstetrics and Gynaecological, has described the research as very impressive.
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